Lesion length of optic neuritis impacts visual prognosis in neuromyelitis optica

Akaishi, Tetsuya; Nakashima, Ichiro; Takeshita, Takayuki; Mugikura, Shunji; Sato, Douglas Kazutoshi; Takahashi, Toshiyuki; Nishiyama, Shuhei; Kurosawa, Kazuhiro; Misu, Tatsuro; Nakazawa, Toru; Akiyama, Masashi; Fujihara, Kazuo

doi:10.1016/j.jneuroim.2016.02.004

Cited by 73 publications

(63 citation statements)

References 7 publications

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“…3 The distribution of the abnormal intensity in double inversion recovery images shows the accumulation of archival lesions throughout the disease course. 5 Magnetic resonance imaging findings of T1weighted images with contrast enhancement have shown that the length of abnormally enhanced lesions in patients with optic neuritis and NMOSD is longer than those in patients with optic neuritis and MS. 5,44 Furthermore, a number of studies, including double inversion recovery imaging studies, have shown that the optic chiasma and intracranial optic nerve are often involved in the optic neuritis of patients with NMOSD compared with the optic neuritis of patients with MS. 5,45 The orbital optic nerve is the most frequently involved site in optic neuritis in patients with both MS and NMO. 5…”

Section: Neuro-ophthalmological Findings In Autoimmune Optic Neuritismentioning

confidence: 99%

Clinical characteristics of autoimmune optic neuritis

Kawachi

2017

Clinical & Exp Neuroim

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Autoimmune disorders of the central nervous system often involve autoimmune inflammation of the anterior visual pathways. Autoimmune optic neuritis can be categorized as: (i) isolated optic neuritis; (ii) relapsing isolated optic neuritis: (iii) chronic relapsing inflammatory optic neuropathy; (iv) neuromyelitis optica spectrum disorders-associated optic neuritis; or (v) multiple sclerosis-associated optic neuritis. Studies of serum-specific autoantibodies, such as aquaporin-4 and myelin oligodendrocyte glycoprotein, have revealed some underlying mechanisms of autoimmune optic neuritis. However, the etiology and pathogenesis of most cases of autoimmune optic neuritis remain unclear. The following clinical features of autoimmune optic neuritis are profoundly affected by the unique structure of the human anterior visual pathways: (i) vulnerability to swelling of the intracanalicular optic nerve as a result of the limited space within the bony canal; (ii) inflammatory cell infiltration through the subarachnoid space, pia and pial septa; (iii) compartmentalized dynamics of cerebrospinal fluid as a result of the culde-sac anatomy of the optic nerve; (iv) permeability of the prelaminar optic nerve head as a result of the lack of classical blood-brain barrier characteristics; and (v) retinal abnormalities, which are a diagnostic window of neurodegenerative processes of the optic nerves and/or brain. Future studies are required to configure a systemic nosology for optic neuritis with international consensus, elucidate specific diagnostic biomarkers, carry out clinical trials of the acute and chronic phases of the disease etiologies, and elucidate possible neuroprotective and remyelinating treatments.

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Section: Neuro-ophthalmological Findings In Autoimmune Optic Neuritismentioning

confidence: 99%

Clinical characteristics of autoimmune optic neuritis

Kawachi

2017

Clinical & Exp Neuroim

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“…Numerous studies have evaluated the visual outcomes in ON without NMO. However, in contrast to isolated ON, much less research has focused on the evaluation of visual outcomes in NMO‐ON . It was found that ON lesion length in the acute phase, the impaired segment of the optic nerve, OCT data from the chronic phase, and onset age were all correlated with visual prognosis .…”

Section: Discussionmentioning

confidence: 99%

“…However, in contrast to isolated ON, much less research has focused on the evaluation of visual outcomes in NMO‐ON . It was found that ON lesion length in the acute phase, the impaired segment of the optic nerve, OCT data from the chronic phase, and onset age were all correlated with visual prognosis . Additionally, previous studies observed an association between AQP4‐Ab positivity and poor visual outcomes .…”

Section: Discussionmentioning

confidence: 99%

Radiomics Analysis of DTI Data to Assess Vision Outcome After Intravenous Methylprednisolone Therapy in Neuromyelitis Optic Neuritis

Tian

Liu

Tang

et al. 2018

Magnetic Resonance Imaging

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Background Neuromyelitis optica‐optic neuritis (NMO‐ON) patients are routinely treated with intravenous methylprednisolone (IVMP). For the patients nonresponsive to IVMP, more effective but aggressive therapy of plasma exchange (PE) should be employed instead of IVMP in the first line. Purpose To assess the visual outcomes of NMO‐ON patients after IVMP by radiomics analysis of whole brain diffusion tensor imaging (DTI) data. Study Type Retrospective. Population In all, 57 NMO‐ON patients receiving IVMP therapy for 3 days. Field Strength/Sequence 3.0T; DTI images acquired by a single‐shot echo planar image sequence; T1 images acquired by 3D fast spoiled gradient echo (3D‐FSPGR) MRI. Assessment In all, 200 DTI measures were extracted from the DTI data and employed as features to construct a radiomics assessment model for visual outcomes of NMO‐ON patients after IVMP. The assessment performance was evaluated by area under the receiver operating characteristic curve (AUC), classification accuracy (ACC), sensitivity, specificity, and positive and negative predicted values (PPV and NPV). The selected DTI measures would reveal the white matter impairments related to visual recovery of NMO‐ON patients. Statistical Tests The relationship between the selected DTI measures and the clinical visual characteristics were investigated by Pearson correlation, Spearman's rank correlation, and one‐way analysis of variance analysis. Results The radiomics model obtained an ACC of 73.68% (P = 0.002), AUC of 0.7931, sensitivity of 0.6207, specificity of 0.8571, PPV of 0.8182, and NPV of 0.6857 in assessing visual outcomes of the NMO‐ON patients after IVMP treatment. The selected DTI measures revealed white matter impairments related to the visual outcomes in the white matter tracts of vision‐relevant regions, motor‐related regions, and corpus callosum. The white matter impairments were found significantly correlated with the disease duration and the length of lesions in the optic nerve. Data Conclusion Radiomics analysis of DTI data has great potential in assessing visual outcomes of NMO‐ON patients after IVMP therapy. Level of Evidence: 2 Technical Efficacy: Stage 4 J. Magn. Reson. Imaging 2019;49:1365–1373.

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“…Although both MOG-IgG and AQP4-IgG seropositive patients have relapsing clinical courses with significant disability (20), a lower female bias and higher predominance of monophasic disease are reported in multiple MOG-IgG–positive cohorts (18,19,21). In addition, radiographic features often distinguish MOG-IgG seropositive TM and ON from their AQP4-IgG counterparts: inflammation of the conus and cauda equina, perineuritic enhancement of the optic nerve, and shorter optic nerve lesion length (20,22). Moreover, functional recovery and steroid responsivity are more frequently reported for MOG-IgG seropositive ON (18,19,21,23,24).…”

Section: Aqp4-igg: a Specific And Pathogenic Humoral Autoantibodymentioning

confidence: 99%